输尿管软镜与经皮肾镜在肾结石患者中的应用及对肾功能凝血功能及氧化应激产物的影响

doi:10.3969/j.issn.1006-6233.2018.09.031

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摘要 目的: 分析输尿管软镜与经皮肾镜在肾结石患者中的应用效果及对肾功能、凝血功能及氧化应激产物的影响。 方法: 回顾性分析2013年1月至2017年10月收治的628例肾结石患者临床资料,按治疗方式不同分为487例对照组和141例研究组。对照组予以经皮肾镜治疗,研究组予以输尿管软镜治疗。比较两组手术情况,肾功能,凝血功能及氧化应激产物,并发症发生情况。 结果: 研究组手术时间多于对照组,术中出血量及住院时间少于对照组,比较有统计学差异(P<0.001),两组结石清除率比较无差异(P>0.05)。术后12h及24h,两组肾功能指标水平均上升,研究组低于对照组,两组患者肾功能在组间、不同时点间和组间·不同时点间的交互作用比较差异有统计学意义(P<0.001)。两组K、R均下降,α、MA均上升,研究组变化幅度更小(P<0.001)。两组MDA均上升,SOD、GSH-Px均下降,研究组变化幅度更小,两组患者氧化应激产物在组间、不同时点间和组间·不同时点间的交互作用比较差异有统计学意义(P<0.001)。两组总并发症发生率比较无差异(P>0.05)。 结论: 输尿管软镜与经皮肾镜在肾结石直径<20mm患者的碎石效果相当,但输尿管软镜对肾功能、凝血功能及氧化应激的影响较小,微创性更明显,可作为此类患者的首选术式。

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关键词 ：肾结石, 输尿管软镜, 经皮肾镜

Abstract：Objective: To analyze the application effect of ureteroscope and percutaneous nephroscope in patients with renal calculi and its effects on renal function, coagulation function and oxidative stress products. Methods: The clinical data of 628 patients with renal calculi from January 2013 to October 2017 admitted in our hospital were retrospectively analyzed. According to the treatment methods, all the patients were divided into 487 control groups and 141 research groups. The control group was treated with percutaneous nephroscope and the research group was treated with ureteroscope. Then surgical effect, renal function, coagulation function and oxidative stress products, complications occurred between two group was compared. Results: The operative time in the study group was longer than that in the control group, and the amount of bleeding and hospitalization time in the study group were less than those in the control group (P<0.001). There was no difference in stone clearance between the two groups (P>0.05). 12h and 24h after operation, kidney function level in both group was increased, while research groups was lower than control group,there were significant differences in renal function between the two groups, between different time points and between groups. The difference was statistically significant (P<0.001). K and R in two group were both decreased,α and MA all increased, range of change in research groups was lower than control group (P<0.001). MDA in both group was increased, SOD and GSH-Px in both group was decreased, while the range of changein research groups was lower than control group, there were significant differences in oxidative stress productbetween the two groups, between different time points and between groups. The difference was statistically significant (P<0.001). Total adverse reaction rate in two group between the two groups was no difference (P>0.05). Conclusion: The effect of ureteroscopy and percutaneous nephrolithotomy in the patients with renal calculi diameter <20mm is similar, but the ureteroscopy has less effect on renal function, coagulation function and oxidative stress. It is more invasive and can be used as the first choice for such patients.

Key words： Kidney stones Ureteroscope Percutaneous nephroscope

基金资助:国家重点实验室开放课题基金,(编号:2007DA780154F0910);2016年深圳市宝安区科技局资助项目,(编号:2016CX079)

引用本文:

向芹, 刘跃光, 李文科, 熊丽, 杜建辉. 输尿管软镜与经皮肾镜在肾结石患者中的应用及对肾功能凝血功能及氧化应激产物的影响[J]. 河北医学, 2018, 24(9): 1522-1526.
XIANG Qin, LIU Yueguang, LI Wenke, et al. Application of Ureteroscope and Percutaneous Nephroscope in Patients with Renal Calculi and its effects on Renal Function, Coagulation Function and Oxidative Stress Products. HeBei Med, 2018, 24(9): 1522-1526.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.09.031 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I9/1522

[1] Alkadhi H, Saltybaeva N. Lost opportunities: radiologists are not sufficiently using reduced-dose CT for kidney stones[J]. Radiology,2018,286(2):590~591
[2] Khan AH, Imran S, Talati J, et al. Fourier transform infrared spectroscopy for analysis of kidney stones[J]. Investig Clin Urol,2018,59(1):32~37.
[3] 王安勇.输尿管软镜术与经皮肾镜碎石术治疗肾结石的临床疗效比较研究[J].实用心脑肺血管病杂志,2017,25(S1):90~91.
[4] Shoar K, Turney BW, Cleveland RO. Tracking kidney stones in a homogeneous medium using a trilateration approach[J].Acoust Soc Am,2017 ,142(6):3715.
[5] Dongre AR, Rajalakshmi M, Deshmukh PR, et al. Risk factors for kidney stones in rural puducherry: case-control study[J].Clin Diagn Res,2017,11(9):LC01~LC05.
[6] Shadman A, Bastani B. Evaluation and management of kidney calculi[J]. Iran J Kidney Dis,2017,11(6):395~407.
[7] 翁依华,刘孙标,郭宪伟.经皮肾镜碎石术治疗复杂性肾结石的临床疗效及对患者肾功能的影响[J].医学综述,2016,22(20):4086~4089.
[8] 廖国栋,俞蔚文,章越龙,等.超微经皮肾镜和输尿管软镜在治疗肾结石中的感染控制及疗效的对比研究[J].中华医院感染学杂志,2017,27(11):2543~2546.
[9] 陈家璧,李毅宁,庄伟.输尿管软镜碎石术与经皮肾镜碎石术治疗肾结石的临床疗效及安全性比较分析[J].微创泌尿外科杂志,2016,5(3):150~153.
[10] 皇甫佳文,颜伟,张菊根,等.经皮肾镜碎石术与输尿管软镜治疗肾结石的临床疗效对比研究[J].河北医学,2016,22(10):1683~1685.
[11] 何龙,李昕,刘龙,等.泌尿系无症状结石手术安全性、有效性及术后肾功能变化的回顾性研究[J].解放军医药杂志,2015,27(6):24~27.
[12] Falahatkar S, Mokhtari G, Amin A, et al. Comparison of the outcomes of complete supine percutaneous nephrolithotomy in patients with radiopaque and radiolucent kidney stones[J]. Turk Urol,2017,43(4):490~496.